Pakistan floods: Caring for older people's well being and self-worth
I am in Nowshera district, visiting older people affected by the Pakistan floods that swept through the country six months ago.
This weekend I visited a rural health centre.
The centre was established last October to provide health services to the 20,000 internally displaced people living in the nearby tented villages.
These people are a mixture of local people from six villages whose home were washed away by the Pakistan floods and Afghan refugees whose previous tents and homes were destroyed.
All are treated equally at the health centre which is supported by HelpAge International, Merlin and UNICEF.
The centre is always busy - every day 300 patients are treated. This is no wonder says the base in-charge, Dr Ashfaq Ahmed.
Despite distributions of winter kits, the tents do not protect against the winter months and respiratory infections have been common, especially among the very young and very old. In fact acute respiratory infections are 50% higher than usual for this time of year.
People traumatised by Pakistan floods
The centre manager is sure that people still feel traumatised by the floods. Mentally, they haven't settled, he says. But it is hard to work with people on this level. They are not used to talking about their feelings.
HelpAge's health promoters who work alongside Merlin's mobile clinic teams try to talk to older people about these issues.
But, "they don't want empathy, they want material things!" says Sanaullah one HelpAge health promoter. If they have those things, if they have a house, they will feel better.
Cash grants stop older people feeling like a burden
Older people feel very vulnerable right now, they are not, for example included in decision-making in the family. They feel they are a burden on their families. Some families do feel this way because of the pressure they are under.
One of the reasons that HelpAge's cash grant has been a huge success is that the older person feels they have some worth in their family. With the money they can contribute to the family's needs.
Likewise, the distribution of wheelchairs has given a freedom that many older people have not had in years.
One man hadn't left his house in years, now he can move around his neighbourhood. A simple intervention can change lives quite dramatically.